--constant, localized twitch left side of tongue--twitching spot is dimpled today and very rough --can't feel the twitch--been going on for four weeks

Reasons to feel a little better:

--don't see it at rest (maybe saw it once, hard to say)-- worse when sticking tongue out, flips out extra hard when halfway extended --age: 27 --came about after four months of tongue self checks for oral cancer (hypochondria)--seems to get worse the more I check it, morning it ain't bad, when I don't check it ain't bad, right now it's so easy to induce

I could elaborate on your issues but as specifically you mentioned, it would not be ethical of me.

PS: Even the dumbest neurologist knows that tongue fasciculations are assessed only when the tongue is resting. You said your tongue does not twitch at rest, yet you still bother us with "tongue fasciculations"...If you do not want to listen, do not ask us...

My point of confusion: are fasciculations identified on resting tongue because they are difficult to see in strained tongue, or because tonge fasciculates when extended? I've read both of these things. When I showed my video every one said tongue fasciculations--which I don't disagree with--yet when tongue is resting floor of mouth, no fasciculations that I can see. Is it possible a nerve in one spot has lost it's connectivity or whatever (not a neuro) and freaks out when tongue is extended? Prior to the tongue I had this issue in my middle finger (except I could feel it). I was completing my thesis, writing all the time, and every time my hand was in a certain position (strained, typing position) the middle finger would twitch. Why is this impossible with the tongue? Why is it ok to strain your eyelid and have a constantly twitching eyelid for six months (like my doc told me he had) and not hve the same thing happen on your tongue??? Why??

In general - when there is a chronic denervation process in place, such as an anterior horn cell disease, the fasciculations appear. While they can vary in their intensity in the beginning, they are still present, no matter whether the muscle is being used or not. The tongue consists of several interlacing muscles and it is extremely difficult to hold it still - protruded (especially mildly) tongue displays fasciculatory movements of individual muscle bundles. Hence the key point is whether they are present at rest - because that would suggest true fasciculation. If there is no movement at rest in that spot, it is not a fasciculation. If your nerve was "loosing connectivity", as you stated, there would be fasciculation at rest and most importantly - there would be over the whole tongue as tongue is innervated by a single nerve, n. hypoglossus (12th cranial nerve). Also fasciculations are ireggular, variable and not really rhythic when it comes to the tongue (sure, there is no hard rule but observations and literature suggests that). It seems that your tongue simply is built the way that when you strain it the way you do, there is a muscle bundle that tries to balance the strenght. But if there is nothing at rest, there is absolutely NO reason to concern. With the eye or the finger, these are often myokimyas or simply a muscle that is too tired - again, if there is no activity at rest, it has nothing to do with MND. This is why fasciculations are called spontaneous activity!

So basically, there is absolutely no reason to be scared - you have no spontaneous activity from what I understand (dont remember if you have fasciculations elsewhere). But with the tongue it is really that simple.